The Gross Clinic, or, The Clinic of Dr. Gross, is an 1875 painting by American artist Thomas Eakins. It is oil on canvas and measures 8 feet (240 cm) by 6.5 feet (200 cm).

Dr. Samuel D. Gross, a seventy-year-old professor dressed in a black frock coat, lectures a group of Jefferson Medical College students. Included among the group is a self-portrait of Eakins, who is seated to the right hand side of the tunnel railing with a white cuffed sleeve[clarification needed] sketching or writing.[1] Seen over Dr. Gross's right shoulder is the clinic clerk, Dr. Franklin West, taking notes on the operation.

Eakins's signature is painted into the painting, on the front of the surgical table.

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Admired for its uncompromising realism, The Gross Clinic has an important place documenting the history of medicine—both because it honors the emergence of surgery as a healing profession (previously, surgery was associated primarily with amputation), and because it shows us what the surgical theater looked like in the nineteenth century.

The painting is based on a surgery witnessed by Eakins, in which Gross treated a young man for osteomyelitis of the femur. Gross is pictured here performing a conservative operation as opposed to an amputation (which is how the patient would normally have been treated in previous decades).

Here, surgeons crowd around the anesthetized patient in their frock coats. This is just prior to the adoption of a hygienic surgical environment (see asepsis). The Gross Clinic is thus often contrasted with Eakins's later painting The Agnew Clinic (1889), which depicts a cleaner, brighter, surgical theater, with the participants in "white coats".[2] In comparing the two, the advancement in understanding of the prevention of infection is seen. Another noteworthy difference in the later painting is the presence of a professional nurse, Mary Clymer, in the operating theater.

It is assumed that the patient depicted in The Gross Clinic was a teenage boy, although the exposed body is not entirely discernible as male or female; the painting is shocking for both the odd presentation of this figure and the matter-of-fact goriness of the procedure.[3]

Adding to the drama is the lone woman in the painting seen in the middle ground, possibly the patient's mother, cringing in distress.[3] Her dramatic figure functions as a strong contrast to the calm, professional demeanor of the men who surround the patient. This bloody and very blunt depiction of surgery was shocking at the time it was first exhibited.

The painting was submitted for the 1876 Centennial Exhibition in Philadelphia, but was rejected by the Committee of Selection. When it was eventually displayed in Ward One of the U.S. Army Post Hospital, a critic for the New York Tribune wrote that it was:

"... one of the most powerful, horrible, yet fascinating pictures that has been painted anywhere in this century...but the more one praises it, the more one must condemn its admission to a gallery where men and women of weak nerves must be compelled to look at it, for not to look at it is impossible."

Another critic, writing in 1885, said:

"It is characterized by so many excellent artistic qualities, that one regrets that the work as a whole fails to satisfy. Admirable draughtsman as this painter is, one is surprised that in the arrangement of the figures the perspective should have been so ineffective that the mother is altogether too small for the rest of the group, and the figure of the patient so indistinct that it is difficult to tell exactly the part of the body upon which the surgeon is performing the operation. The monochromatic tone of the composition is, perhaps, intentional, in order to concentrate the effect on the bloody thigh and the crimson finger of the operating professor. But as it is, the attention is at once and so entirely directed on that reeking hand as to convey the impression that such concentration was the sole purpose of the painting. In similar paintings by Ribera, Regnault,[4] and other artists of the horrible, as vivid a result is obtained without sacrificing the light and color in the other parts of the picture; and the effect, while no less intense, is, therefore, less startling and loud."[5]

These assessments were not universal. The critic for Philadelphia's The Evening Telegraph, who may have been aware of the personal politics involved in the advisory group of artists who rejected it, wrote:

"There is nothing so fine in the American section of the Art Department of the Exhibition, and it is a great pity that the squeamishness of the Selecting Committee compelled the artist to find a place for it in the United States Hospital building. It is rumored that the blood on Dr. Gross' fingers made some of the members of the committee sick, but, judging from the quality of the work exhibited by them we fear that it was not the blood alone that made them sick. Artists have before now been known to sicken at the sight of pictures by younger men which they in their souls were compelled to acknowledge were beyond their emulation."[6]

Controversy about the painting has centered on its violence, and on the melodramatic presence of the woman. Modern scholars have suggested that the painting may be read in terms of castration anxiety and fantasies of mastery over the body (e.g. Michael Fried), and that it documents Eakins's ambivalence about representing sex difference (e.g. Jennifer Doyle). The painting has also been understood to be drawing an analogy between painting and surgery and as identifying the work of the artist with the emergence of surgery as a respected profession.

In 2002 Michael Kimmelman of The New York Times called it "hands down, the finest 19th-century American painting".[3] In 2006, in response to the impending sale of this painting, The New York Times published a "close reading" which sketches some of the different critical perspectives on this work of art.[7]

The proposed sale was seen as a secretive act.[9] In late November 2006, efforts began to keep the painting in Philadelphia, including a fund with a December 26 deadline to raise money to purchase it and a plan to invoke a clause regarding "historic objects" in the city's historic preservation code. In a matter of weeks the fund raised $30 million, and on December 21, 2006, Wachovia Bank agreed to loan the difference until the rest of the money has been raised, keeping the painting in town at the Philadelphia Museum of Art and the Pennsylvania Academy of Fine Arts.

The painting has been restored three times. The first restoration between 1917 and 1925 substantially damaged the painting, rendering secondary figures in the composition inconsistently bright or reddish in color.[11] In 1929, Susan Macdowell Eakins, the artist's widow, wrote a letter of complaint regarding the "fancy red light' that had falsified the painting's intended tones.[1][11][12]

The painting's backing was reinforced with plywood by H. Stevenson in 1915. This was replaced in 1940 by Hannah Mee Horner, who glued the painting to a plywood backing. Within two decades this backing began to warp and threatened to tear the painting in half.[13]

In 1961, at the request of Jefferson Medical College, the Philadelphia Museum of Art (PMA) undertook another restoration, under conservator Theodor Siegl.[14] Mark Tucker, a later PMA conservationist, described the work as "a rescue mission... They were saving the painting from tearing itself in half. These were the nail heads that were starting to work forward into the canvas and show as bumps on the front... Yeah. It was just hair-raising."[15] Siegl used a power plane to remove the plywood down to the last, thin ply. The rest of the wood and the tenacious glue were painstakingly removed by hand. Siegl and his colleagues also restored, to some extent, the faces in the upper right of the canvas.[12][15]

In 2009, in response to long term concerns regarding inconsistencies in the painting's disposition of darkness and light, conservators at the Philadelphia Museum of Art undertook restoration of The Gross Clinic from July 2009 to July 2010, during which time the painting was not publicly visible.[11] The restoration sought to revert changes that had been made by the Jefferson Medical College during the 1917 restoration. Definition of parts, including Eakins' self-portrayal, was restored, using as reference an ink wash copy of the painting made by the artist, as well as a photograph taken by the Metropolitan Museum of Art previous to the Medical College's changes in 1917.[11][16]

"Thomas Eakins's The Gross Clinic". Philadelphia Museum of Art (website). Philadelphia Museum of Art. Retrieved 2011-06-04. — Description of previous and current conservation and restoration work on the Eakins painting.